Atrial fibrillation in Mediterranean spotted fever.
Mediterranean spotted fever (MSF) is a tick-borne acute febrile disease caused by Rickettsia conorii and characterized by fever, maculo-papular rash and a black eschar at the site of the tick bite ('tache noir'). We describe the case of a 58-year-old man affected by MSF who developed atrial fibrillation. The patient presented himself to the hospital after 7 days of fever, malaise and severe headache. Cardiac auscultation revealed a chaotic heart rhythm and an electrocardiogram confirmed atrial fibrillation with a fast ventricular response. Diagnosis of MSF was made after the appearance of a maculo-papular skin rash, and treatment with oral doxycycline was started. An immunofluorescence antibody test confirmed R. conorii infection. The patient recovered after 7 days of treatment. Cardiac arrhythmia is a rare complication of MSF. Inflammation may play a role in the pathogenesis of atrial fibrillation. R. conorii is an intracellular bacterium which could trigger atrial fibrillation. Our patient was previously healthy and had no reported history of cardiac disease. This suggests that heart function should be monitored in MSF patients even in the absence of underlying risk factors.
Colomba
Claudia
C
Dipartimento di Scienze per la Promozione della Salute, Sezione di Malattie Infettive, Università di Palermo, Via del Vespro 129, 90127 Palermo, Italy.
Saporito
Laura
L
Dipartimento di Scienze per la Promozione della Salute, Sezione di Malattie Infettive, Università di Palermo, Via del Vespro 129, 90127 Palermo, Italy.
Colletti
Pietro
P
Dipartimento di Patologie Emergenti, Clinica delle Malattie Infettive, Azienda Ospedaliera Universitaria Policlinico 'Paolo Giaccone', Via del Vespro 129, 90127 Palermo, Italy.
Mazzola
Giovanni
G
Dipartimento di Patologie Emergenti, Clinica delle Malattie Infettive, Azienda Ospedaliera Universitaria Policlinico 'Paolo Giaccone', Via del Vespro 129, 90127 Palermo, Italy.
Rubino
Raffaella
R
Dipartimento di Scienze per la Promozione della Salute, Sezione di Malattie Infettive, Università di Palermo, Via del Vespro 129, 90127 Palermo, Italy.
Pampinella
Diego
D
Dipartimento di Scienze per la Promozione della Salute, Sezione di Malattie Infettive, Università di Palermo, Via del Vespro 129, 90127 Palermo, Italy.
Titone
Lucina
L
Dipartimento di Scienze per la Promozione della Salute, Sezione di Malattie Infettive, Università di Palermo, Via del Vespro 129, 90127 Palermo, Italy.
D001281:Atrial Fibrillation / Q000209:etiology*; D001907:Boutonneuse Fever / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged